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Care Teams Report Form

Please take a few minutes to complete this form and submit no later than Sunday evening.
Thank you!

Care Team Report Form

"*" indicates required fields

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This field is for validation purposes and should be left unchanged.

Your first name*

Your last name*

I am on team...*

Name of person contacted*

First contact*

Were there subsequent contacts?*

Yes

Subsequent contact

Method of contact*

Phone call

Text

In person visit

Other

Describe 'other' method of contact*

Contact details*

Is any further follow-up required?*

Yes

Do you wish to continue following up with this person in a LIFE on LIFE (LOL)?*

Yes

What follow-up is required?*

Person has consented to...*

To provide clarity on consent around information sharing, please ask who this prayer request can be shared with.

What is the prayer request?*

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